Modern humans tend to love very lopsided lives when it comes to sports, daily habits, how we sit for work and how we hold babies, purses, backpacks etc.
Many people are walking around with a pelvic or hip instability issue without even knowing it. This is because the human body is amazing at compensating. It will compensate and compensate, sometimes for years without any pain at all…until one day it can’t take any more, and that’s when we get a pain signal.
The list of possible injuries or pain patterns that can happen due to a hip instability pattern are so numerous we’d be here all day if I went into them all, but the big surprise is plantar fasciitis.
If you’ve tried all the typical routes or methods of eliminating plantar fasciitis and your pain persists, it could be due to an underlying hip or pelvic instability issue. (Click here to learn about the most common causes of plantar fasciitis).
The short story on this complex issue:
Due to one or more imbalances in the fascia of the legs, your pelvis can experience a tilt, shift or rotation (or some combination thereof). This means it could be rotated forward on one or both sides, tilted to the left or right or otherwise shifted out of alignment.
When this happens, it is my belief that your brain detects potential danger to the central nervous system and spine (which requires a neutral pelvis to be at optimal health), and recruits one or more muscles of the low back or hip to contract neurologically to bring you back into balance.
Often, it’s the gluteus medius that is recruited this way and when it is – that muscle is no longer able to be recruited for its normal duties.
What does the gluteus medius do?
Gluteus medius and minimus abduct the thigh when the leg is straight and during gait (walking or running) these two muscles function to support the body on one leg to prevent the pelvis from dropping to the opposite side.
With the hip flexed, gluteus medius and minimus internally rotate the thigh. With the hip extended, they externally rotate the thigh, or more accurately they act to prevent internal rotation. Without this action the knee migrates inward, creating stress on the structures of the hip, knee and foot.
As you can tell, gluteus medius (and minimus) are critical for hip stability in ALL kinds of everyday actions. If one or both of these muscles is no longer able to do its job, it has to be done by other muscles.
How glute inhibition or hip instability leads to plantar fasciitis:
This is part 2 of our 5 part series on understanding Plantar fasciitis. Click here for Part I and learn exactly what plantar fasciitis IS and what is causing it.
What’s in a name?
Have you ever noticed that we’re obsessed with naming things? We’ve given every pain in the body a title that includes something like itis, syndrome, disorder or disease on the end. We name viruses and flu strains, and there a lot of people who name their tumors when they get cancer.
In some ways, I get this: when we name something, it feels familiar and less scary. The unfamiliar or unknown feels scary.
However, I believe we’re doing ourselves a massive disservice with all this naming (at least when it comes to pain in the body).
Naming something does practically nothing to help us understand what’s happening or how to reverse it. What it does instead is allow us to take ownership of it. We say things like “I have sciatica.” “I have cancer.” “I have plantar fasciitis.”
“To have”: to hold, possess, accept; to get, receive or take.
Do you really want to hold, posses, accept, receive or take a named pain? Or do you want to find its root cause and eliminate it?
Instead of naming pain, let your body talk to you:
When you know how to interpret your body’s signals, not only will pain stop feeling scary but you’ll very likely quit wanting to name it. Instead, you’ll let your body talk to you. Every “negative” (painful) sensation is your body’s way of trying to communicate to and work with you, so you can both feel unstoppable and live a long healthy life. Your body isn’t trying to annoy or betray you, it’s asking for HELP.
When you look up ‘plantar fasciitis’ online it is almost always described as pain that shows up in the heel where the Achilles tendon meets the plantar fascia.
However, not everyone that experiences plantar fasciitis has pain there.
A LOT of you are experiencing pain in the ARCHES of your foot, maybe even under the ball or big toe.
Some of you may have BOTH at once – pain in the heel AND pain in arches.
Some of you have pain in BOTH feet; and some of you in only one.
Maybe you have pain in the arches on ONE foot and pain in the heel on the other…
Every one of these scenarios suggests a different root cause, possibly multiple and compounding causes!
This is one reason why I’m not fond of naming pain (be it plantar fasciitis, sciatica, ITBS etc), because when we do this, all the important factors – where the pain is, what it feels like, how it might jump around or move depending on activities etc – get lost and we focus on “having” and owning whatever name we’ve been assigned, instead of listening to our body and trying to interpret what it’s telling us.
Only by getting curious about what your body is telling you (feedback via sensation, immobility issues or pain through certain ranges of motion etc) will we start to unravel the puzzle and discover the root cause.
Pain doesn’t happen in a vacuum – it happens out there, in the ever-changing dynamics of life and how you are engaging your body in the world.
To reverse pain quickly and efficiently, we have to look at it out there as well, in the ever-changing dynamics of life and how you are engaging your body in the world. This is why, when I work with people one on one, I have them walk, lunge, jump, step up or down or go run outside in the parking lot – whatever movements get their body talking to them (and me).
Muscle attachments tell us a LOT:
When you start to tune in to your body and listen, you’ll notice where the pain is, what it feels like, whether it radiates or is sharp and stabbing, and whether or not it moves around throughout the day.
The most obvious and easy to understand “clue” your body gives is WHERE the pain is.
As you can see from this picture, clues appear when we note that the Achilles tendon attaches near the site of pain.
If you have classic plantar fasciitis in the heel only, chances are high your Achilles tendon is tight – and if your Achilles tendon is knotted up or restricted, chances are so is your gastrocnemius and/or soleus fascia.
If you have outside heel pain, in your case maybe it’s the peroneus muscles that run along the outside or lateral part of the calf compartment and THROUGH the lateral heel and ANKLE that are restricted.
Some of you have pain on the INSIDE of your heel, and when we look at that anatomy we see the medial soleus and gastroc muscles, the toe flexor muscles and tibialis posterior.
All of these muscles are the ones CLOSEST to or directly upstream of the foot, and MIGHT be contributing to your plantar fasciitis but it’s important to remember that it could also be something further upstream, or perhaps these muscles being restricted are a symptom of something else (a bigger overall issue such as a hip instability patter – which we’ll talk about in Part 5 of this series).
This is ALL valuable information because WHERE your pain is points to exactly WHERE you need to go to get relief.
Don’t worry, you don’t need to become an anatomy nerd to get yourself out of pain!
That’s where I come in.
I’ve learned most of the plantar fasciitis patterns by now, and I want to take what I’ve learned to help you get – and stay – out of pain.
If you’re in pain right now and want relief in as little as one week, then I want to help you walk away from PF for good!
Break Up With Your PF™ - Say Goodbye to Plantar Fasciitis For Good!